Bone and joint mycobacterial infection: a retrospective review of cases presenting to a UK district hospital
| Autor: | David A Enoch, A. Everden, D. Somasunderam, J. P. Mamo, A. McKee, S. O. Brij |
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| Rok vydání: | 2018 |
| Předmět: |
Microbiology (medical)
Adult Male medicine.medical_specialty Tuberculosis 030231 tropical medicine Antitubercular Agents Microbiology Tuberculosis Osteoarticular 03 medical and health sciences Young Adult 0302 clinical medicine Weight loss Internal medicine District hospital Biopsy Epidemiology Drug Resistance Bacterial medicine Humans 030212 general & internal medicine Aged Retrospective Studies Aged 80 and over Retrospective review medicine.diagnostic_test business.industry General Medicine Middle Aged medicine.disease United Kingdom Lumbar spine Female Presentation (obstetrics) medicine.symptom business |
| Zdroj: | Journal of medical microbiology. 67(12) |
| ISSN: | 1473-5644 |
| Popis: | Purpose. Peterborough has one of the highest rates of tuberculosis (TB) in the east of England. We reviewed the epidemiology, management and outcome of all cases of bone and joint TB (BJTB) diagnosed since 2000. Methodology. Retrospective review of all adult cases of BJTB between 1 January 2000 and 31 December 2015. Patients’ notes were reviewed with regard to their presentation, investigation, management and outcomes. Results. In total, 21 patients diagnosed with BJTB were reviewed. Thoracic and lumbar spine were the most common sites affected (62 %). The most common clinical manifestations included localized pain (76 %), fever (53 %) and weight loss (48 %). Fourteen (67 %) patients had a bone biopsy or aspirate sent for microbiological investigation; none were smear-positive, but 11 were culture-positive. Eleven patients (77 %) were fully susceptible to anti-tuberculous drugs, one was isoniazid-resistant and one was pyrazinamide-resistant. Anti-tuberculous therapy was given for 6–16 months. Nineteen (90 %) patients completed therapy. Conclusions. BJTB requires a high index of clinical suspicion. BJTB should be considered in any patient with unexplained pain, fever and weight loss. The diagnosis is proven by aspiration and biopsy and should be undertaken as soon as possible for culture purposes, as microscopy alone can be negative. |
| Databáze: | OpenAIRE |
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